Daim Ntawv Pov Thawj Qhia Txog Kev Kawm Txog Kev Saib Xyuas Hauv TotalCare (D-SNP)

Cov Lus Qhia Txog Kev Pom Zoo
Raws li cov kev cai ntawm Lub Chaw rau Medicare & Medicaid Services (CMS) nyob rau hauv 42 CFR §§ 422.152(g), 422.107, thiab Tshooj 5, Tshooj 40 ntawm Medicare Managed Care Managed Manual, nrog rau California Department of Health Care Services (DHCS) D-SNP Policy Guide, txhua tus neeg muab kev pab thiab cov koom haum koom nrog hauv TotalCare (HMO D-SNP) Dual Eligible Special Needs Plan (D-SNP) network yuav tsum ua tiav kev cob qhia txhua xyoo ntawm Tus Qauv Kev Saib Xyuas (MOC) uas tau pom zoo los ntawm Txoj Kev Npaj.

Los ntawm kev xa cov ntaub ntawv hauv qab no, kuv ua pov thawj sawv cev rau kuv tus kheej thiab/lossis lub koom haum uas tau teev saum toj no tias:

1. Kuv (thiab/lossis txhua tus neeg muab kev pabcuam thiab cov neeg ua haujlwm uas tau ua haujlwm/tau cog lus nrog TotalCare (HMO D-SNP) cov tswv cuab) tau ua tiav qhov Kev Kawm Txuj Ci Saib Xyuas uas TotalCare (HMO D-SNP) muab rau xyoo tam sim no.
2. Kuv nkag siab tias kev ua tiav qhov kev cob qhia no yog ib qho yuav tsum tau ua ntawm kev koom nrog hauv TotalCare (HMO D-SNP) network.
3. Cov ntaub ntawv ua tiav lawm khaws cia thiab TotalCare (HMO D-SNP) muaj rau kev tshuaj xyuas thaum thov.
4. Kuv lees paub tias kev ua tsis tau raws li qhov yuav tsum tau ua no yuav cuam tshuam rau kuv/peb txoj kev koom tes hauv TotalCare (HMO D-SNP) network.